Provider Demographics
NPI:1467229310
Name:ONEAL, SHAWANNA DENISE (LMT)
Entity Type:Individual
Prefix:
First Name:SHAWANNA
Middle Name:DENISE
Last Name:ONEAL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 DRESAGE LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-7820
Mailing Address - Country:US
Mailing Address - Phone:469-267-9963
Mailing Address - Fax:
Practice Address - Street 1:3716 DRESAGE LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-7820
Practice Address - Country:US
Practice Address - Phone:469-267-9963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT120164225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist